| Kingdom Autism And Behavioral Health, Llc | |
|
397 Railroad Street Suite Number #4 St. Johnsbury VT 05819 | |
| (802) 999-2513 | |
| Not Available |
| Full Name | Kingdom Autism And Behavioral Health, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 397 Railroad Street, St. Johnsbury, Vermont |
| Authorized Official Name and Position | Courtney Daffinrud (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8029992513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingdom Autism And Behavioral Health, Llc 878 Ridge Road Lyndonville VT 05851 Ph: (802) 999-2513 | Kingdom Autism And Behavioral Health, Llc 397 Railroad Street Suite Number #4 St. Johnsbury VT 05819 Ph: (802) 999-2513 |
| NPI Number | 1447797873 |
|---|---|
| Provider Enumeration Date | 01/24/2017 |
| Last Update Date | 05/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447797873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 146.0126738 (Vermont) | Primary |
Nek Therapeutic And Educational Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 301 Pearl Street, Suite 101, St. Johnsbury, VT 05819 Phone: 802-731-1954 |